HUN 3403 Fall 2012 Review for final exam included all the chapters and student presentations after our second exam Adolescent body composition including fat mass lean mass and skeletal mass changes during puberty Puberty time frame during which the body matures from child to adult o Sexual Maturation Rating SMR for girls and boys Tanner stages Stage 1 pre pubertal growth Stages 2 5 occurrence of growth Females menarche stage 4 Stage 5 sexual maturation o Puberty correlates with changes in Weight Approximately 10 15 lbs yr body composition Girls increase in fat mass Boys decrease in fat mass Skeletal mass By 18yrs more than 90 of adult skeletal mass is formed Dependent on o Genetics o weight bearing exercise o smoking o alcohol o diet calcium phos vit D protein o Large variation in rate of development Males late bloomers often feel inferior more likely to turn to supplements for increased muscle and linear growth Females Mature early and are more likely to adopt grown up behaviors younger o Females Average lean body mass falls from 80 to 74 of body weight Average body fat increases from 16 to 27 at full maturity o Males 44 increase in lean body mass 120 in body fat during puberty Peak weight gain coincides with the timing of peak linear growth and peak muscle mass accumulation During peak weight gain adolescent males gain an avg of 20 lb per year Early mature girls are more likely to Have an eating disorder Have poorer body image Servings of vegetables consumption during adolescence 30 consume 1 serving of vegetables day The influence factors of eating behaviors in adolescent Initiate grown up behaviors younger such as smoking drinking and sexual activity Factors peer influences parental modeling food availability food preferences cost convenience personal and cultural beliefs mass media and body image Food behaviors o Meal skipping breakfast is the most commonly skipped meal o Unhealthy dieting practices o Less meals with family More frequent family meals associated w dietary intake o High consumption of food in fat sugar 30 consume 1 serving of vegetables day 57 f 62 m consume 1serving of fruit day o More snacks soft drinks are the most commonly chosen snacks for adolescent females o Fast food less time with family and more time with peers at places such as fast food restaurants because they offer a social setting with cheap food They eat fast food 2x wk 16 17 of energy intake among females males NHANES 2003 04 Natural food sources of vitamin D Natural Animal sources Found in fatty fish and milk Alternate sources fortified soy milk fortified breakfast cereals ADULT NUTRITION Stages of adulthood Early Adulthood 20 s and 30 s Middle Adulthood 40 s and 50 s Older Adulthood 60 s and up Menopause definition and common symptoms iron needs before and after menopause Menopause cessation of menses The need for iron decreases from 18 to 8 mg daily Loss of healthful benefits of estrogen leads to o Atrophy of tissues in the urinary tract and vagina o Increased abdominal fat o Greater risk for chronic conditions such as osteoporosis and heart disease o Bone loss rate of 1 2 yr over next 10 yrs osteoporosis o Blood lipid levels T Chol LDL HDL Menopause is associated with but not the cause of weight gain and decreases in muscle mass Menopausal effects hot flashes fatigue sleep disturbances memory loss Treatment options HRT teas herbals dietary supplements creams o Black cohosh hot flashes o Phytoestrogens hormone like substance found in plants Phytoestrogens can bind to estrogen receptors and mimic estrogen and anti estrogen effects If estrogen levels are low phytoestrogens can supplement endogenous estrogen Differences among different types of vegetarian diets Know how to calculate energy expenditures with equations Determining energy needs changes in body weight are due to a complex system of interactions including o Gender body size muscle mass o Activity levels o Health status o Hormones o Individual variation Basal Metabolic Rate BMR measuring energy expenditure in an individual who has been awake less than 30 minutes and is still at absolute rest fasted for 10 hours or more and is in a quiet room with normal comfortable temperatures measuring energy expenditure in an individual who has fasted had no vigorous physical activity prior to the test has been given time to relax for 30 minutes before starting measurement and is in a quiet room with comfortable temperatures Resting Metabolic Rate RMR Energy needs are based on o BMR basal metabolic rate BMR differs from RMR resting metabolic rate o is more difficult to obtain o TEF thermic effect of food o Activity thermogenesis exercise activity contributes 60 75 of total daily energy expenditure Harris Benedict Equation BMR 69 o Males 66 5 13 75 x wt 5 x ht 6 8 x age o Females 655 9 6 x wt 1 8 x ht 4 7 x age o Wt kg Ht cm age years Mifflin St Jeor RMR 82 more accurate o Males 10 x wt 6 25 x ht 5 x age 5 o Females 10 x wt 6 25 x ht 5 x age 161 o Wt kg Ht cm age years Injury factors o 1 2 minor surgery o 1 35 skeletal trauma o 1 44 elective surgery o 2 1 2 5 severe thermal burns Activity factors o 1 2 sedentary or wt maintenance o 1 55 moderately active 3 5 days wk o 1 725 very active Weight change o 3500 kcal 1 lb o So to lose 1 lb in a week 3500 kcal Decline in metabolic rate energy expenditure with age o 2 decline per decade in adulthood o Correspond w declines in physical activity lean muscle mass Understand and remember acceptable macronutrient distribution ranges deficit 7days 500kcal deficit per day Recommended dietary fiber for males and females Protein 10 35 Fat 20 35 Carbohydrate 45 65 38 g for men 25 g for women OR 14 g 1000 kcal ELDERLY NUTRITION Definitions 65 74yrs young old 75 84yrs aged 85 and up oldest old Longevity depends on Longevity length of life it is a measure of life s duration in years 19 on genetics 10 on access to high quality health care 20 on environmental factors i e pollution 51 on lifestyle factors i e diet exercise Life expectancy in the US Life expectancy average of years of life remaining for persons in a population group Life expectancy has in US and is expected to continue to Females 79 8 years Males 74 4 years Persons aged 85 years and older are the fastest growing segment of the population It is difficult to meet vitamin and mineral needs when calorie levels below Animal studies show that an energy restricted diet that meets micronutrient needs can prolong healthy life Calorie restriction decreasing the